Student Orientation Booklet

Alaska Regional Hospital
Brigham City Community Hospital
Cache Valley Specialty Hospital
Eastern Idaho Regional Medical Center
Lakeview Hospital
Lone Peak Hospital
Mountain View Hospital
Ogden Regional Medical Center
St. Mark’s Hospital
Timpanogos Regional Hospital
STUDENT
ORIENTATION
BOOKLET
Revised 11/14 MSU
Welcome to our Hospitals!
We believe in you as future healthcare providers and leaders in
the healthcare industry. This booklet contains practice
guidelines that will help guide you through your clinical
experience. It is our expectation that you familiarize yourself
with the contents of this booklet prior to joining us for your
clinical experience.
Mission Statement:
MountainStar Hospitals are the center of medical excellence in our community,
dedicated to compassionate, high quality healthcare.
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We recognize and affirm the unique and intrinsic worth of each individual.
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We treat all those we serve with compassion and kindness.
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We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live our lives.
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We trust our colleagues as valuable members of our healthcare team and pledge to treat one another with loyalty,
respect, and dignity.
HCA Company Mission, Values and Philosophy
Philosophy:
We believe the following principles to be true and timeless:
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Our number one focus will always be on patient care.
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We are committed to caring for people with compassion and kindness.
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We are committed to consistently providing high quality care and service to our patients.
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We will work closely with and enthusiastically support the communities which we serve.
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Our success is dependent upon attracting, developing and retaining our greatest asset - our people.
We will foster an environment that:
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Treats all people with dignity and respect.
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Involves the patient in their care by using bedside shift report.
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Encourages open and honest communication.
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Emphasizes and rewards teamwork.
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Builds loyalty and trust.
We believe in holding people accountable to our values and principles through fair and accurate metrics.
We believe our business is best managed and run at the local level, giving responsibility and authority to those
closest to the delivery of patient care.
We will continue to evolve and grow our business in order to successfully fulfill our mission while unswervingly
adhering to our values and principles.
We will constantly look for ways to innovate and improve the quality of our care and service.
We will maintain a strong, viable financial position which will continue to deserve the respect and give
confidence to our shareholders.
Our Mission & Values:
Above all else, we are committed to the care and improvement of human life. In recognition of this commitment,
we strive to deliver high quality, cost effective healthcare in the communities we serve.
In pursuit of our mission, we believe the following value statements are essential and timeless.
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We recognize and affirm the unique and intrinsic worth of each individual.
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We treat all those we serve with compassion and kindness.
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We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live
our lives.
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We trust our colleagues as valuable members of our healthcare team and pledge to treat one another with
loyalty, respect and dignity.
MountainStar Hospitals
Customer Service Culture
Interaction with Others
Smile and offer a warm, sincere greeting to each and every individual.
Use the person’s preferred name. Introduce yourself.
Use proper telephone etiquette such as answering within three rings and with a smile. Introduce yourself
and state what unit you are on.
Ask permission to put the caller on hold and minimize hold time and transfers when possible.
Be proactive in offering assistance to patients, families, visitors, physicians and staff.
Resolving Concerns
Listen when people complain - don’t be defensive. Show consideration, respond quickly, and be sure to say
what you can do, not what you can’t do.
If you receive a complaint, take ownership of that complaint. If you cannot resolve the complaint yourself,
find someone who can.
Please report concerns or complaints to your instructor.
Taking Pride in MountainStar Hospitals
Create a positive work environment. Practice teamwork by respecting and supporting your co-workers
throughout the hospital.
Help maintain the cleanliness and safety of the hospital environment.
Student
Expectations
Student Requirements
Accredited Educational Programs
Students must be from educational programs that are accredited by National or State accrediting bodies.
Education Affiliation Agreement
The school (college, university, school program) must be covered by a current affiliation agreement with the health care provider
before requesting an educational experience/rotation with the hospital or clinical service area. Students and/or instructors can
contact their school representative or the health care provider to verify an agreement is in place.
Verification & Documentation
All students, and on-site clinical faculty, must have completed and submitted the “Clinical Checklist” and attachments to their
faculty prior to the first clinical experience. This will include:
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Student/Faculty Health Questionnaire form
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Verification of vaccination
o TB/MMR/Influenza/Hepatitis B/Varicella
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Current copy of Basic Life Support for Health Care Providers card
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Signed copy of the Confidentiality and Security Agreement form
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Student Background Investigation encompassing 7 years and multiple counties in area of permanent residence.
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Timely drug and alcohol screen
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Current American Heart Association (AHA) HealthCare Provider BLS Certification
Code of Conduct/Ethics
As part of our commitment to provide quality care to our patients, the staff of MountainStar Hospitals strives to ensure an ethical
and compassionate approach to healthcare delivery and management. We must demonstrate that we act with absolute integrity in
the way we do our work and the way we live our lives. All hospital employees, as well as students, share the responsibility of
observing the code of ethics. The following applies to all employees and students:
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Information concerning patients, employees, and other hospital business of a confidential nature must not be discussed
outside the hospital, or within public places.
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Physicians have the training, primary responsibility, and legal right to diagnose and treat human illness and injury.
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Personal conduct in private and professional life should be consistent with the image that the hospital wants to project to
patients, visitors, and the general community.
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Discussing personal issues/problems with patients is not appropriate.
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Maintain a professional relationship with patients. Associating, dating, or fraternizing with patients on leave, in
treatment, or after discontinuance of treatment is unprofessional and is strictly prohibited, as is any attempt to engage a
patient or former patient in a sexual or intimate relationship.
To get help with an ethics or compliance concern or to report a potential violation of the Code of Conduct, contact your Instructor, a
member of hospital management, the hospital Ethics & Compliance Officer, or the Ethics Line at 1-800-455-1996.
Professional Attire
All employees and students should present the best possible professional image to the hospital’s patients and visitors. Student
uniforms and student identification must be worn when working in the medical center. Uniforms should be clean, pressed, stain
free, in good condition and appropriately sized. Undergarments should be worn; the outline, color of the undergarments, or any
portion of the undergarments should not be visible. Strong perfumes, colognes, body odor and lingering tobacco smoke are not
acceptable. Tattoos must be covered.
Hair should be clean, neat, well groomed, of a natural human color and should not touch the patient. Extreme hairstyles should be
avoided. Jewelry should be kept to a minimum and appropriate for the work area. No visible body piercing jewelry (including
tongue piercing) is allowed, other than 2 sets of earrings. Students with ear gauges will be expected to wear flesh colored plugs
while working. Fingernails should be clean, well manicured, and extend no more than ¼ inch from the tip of the finger; no artificial
nails are allowed in patient care settings.
Socks or hose must be worn. Shoes should be clean, provide safe and secure footing, offer protection from hazards and cover the
foot. White clinical shoes or white tennis shoes with minimal coloring are encouraged. Street shoes are unacceptable.
For warmth, turtlenecks, lab coats, scrub jackets, or cardigan sweaters are acceptable, while sweatshirts of any kind are
unacceptable. Isolation gowns are not acceptable for warmth.
Parking
The hospital provides designated employee parking areas; students are expected to park in “Employee Parking” areas. Vehicles
parked inappropriately are subject to towing/booting and fines. Notify security if you require an escort to your vehicle.
Smoking
All MountainStar Hospitals are tobacco free hospitals. Smoking or using vaporized nicotine delivery devices is not allowed on any
campus.
Security/Theft
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Students are encouraged not to bring excessive amounts of money or valuables. The hospital cannot be responsible for
loss or theft of personal items.
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Hospital property may not be removed from the premises. Notify security immediately if you see any criminal activity.
Drug-free Workplace
The sale, manufacture, distribution, purchase, use, possession or working while impaired by intoxicants, non-prescribed narcotics,
hallucinogenic drugs, marijuana or other non-prescribed controlled substances is prohibited while on hospital property or during
working hours. The distribution, sale, purchase, use or possession of equipment, products and materials which are used, intended
for use, or designed for use with non-prescribed controlled substances also is prohibited while on hospital property. Reporting to,
or being at the hospital with a measurable quantity of non-prescribed narcotics, hallucinogenic drugs, marijuana or other nonprescribed controlled substances in blood or urine is prohibited. Reporting to, or being at the hospital, with a measurable quantity
of prescribed narcotics in blood or urine or use of prescribed narcotics is also prohibited where, in the opinion of the hospital, such
use prevents the student from performing the duties of patient care or poses a risk to the safety of the student, other persons or
property.
If the hospital has reason to believe that a student is impaired by intoxicants, drugs or narcotics, or is in possession of any
intoxicants, drugs, narcotics or equipment, products and materials that are used, intended for use, or designed for use with nonprescribed controlled substances, the student will be removed from the clinical site and the school/faculty will be notified
immediately. Program participants will be required to undergo drug and alcohol testing at the suspicion that the participant has
violated the policy.
Personal Telephone Calls
Personal phone calls must be limited to calls of an urgent or emergency nature only. Personal calls of a non-urgent/emergency
nature are to be made from a public telephone, break room telephone, or personal cell phone during break times. Personal cell
phones must be turned off while on duty.
Quality/Safety
Our mission is “provide compassionate, high quality healthcare”. In order to accomplish this mission, the Hospital puts a high
priority on Quality and Safety. If a student has concerns about safety or quality of care provided by the hospital, he or she should
report it to management immediately.
Patient Interaction
MountainStar Hospitals strongly supports and advocates providing the best care to our customers throughout the facility. Patients
and family members expect nurses and other health care providers to be technically competent in their role, but the interpersonal
skills of their healthcare providers have the greatest impact on patients’ overall satisfaction with the hospital experience. We ask
that you remember this as you interact with patients and family throughout your day:
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Introduce yourself and explain your role to the patient.
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As a student, please ask permission of the patient to participate in their care for the day.
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Call patients and visitors by their preferred names.
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Appropriate touch, such as a handshake or touch on the arm or shoulder.
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Review expectations and/or plan of care, and what you are doing to meet them.
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Take time to listen, explain, escort, relate.
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Each time you interact with someone, remember our dedication to compassionate, high quality healthcare.
Student
Health
INFECTION CONTROL
Illness can be spread from patient to patient, between employees and patients, and from employee to employee.
HYGIENE ETIQUETTE:
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Always cover your mouth when coughing or sneezing. Wash hands.
Wash hands before eating.
Wash hands after restroom use.
Wash hands before and after any direct patient care activity or procedure.
Always wash hands after removing personal protective equipment.
Wash hands before and after smoking.
Wash hands before handling any medications
Remind patients to wash their hands.
Offer a surgical mask or tissues to visitors and patients who exhibit cold or flu-like symptoms.
Stay home if you are sick with fever and cough.
Jewelry, chipped nail polish, and artificial nails all have difficult to clean cracks and crevices and should not be worn
in the workplace.
HANDWASHING PROCEDURE:
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Alcohol based products are 99.9% effective at killing organisms. Alcohol products cannot be used if hands are visibly
soiled or if caring for a patient with Clostridium difficile.
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If washing hands with soap and water, run hands under warm water, use enough soap to form a good lather, scrub hands
for at least 15 seconds or more, rinse with water, dry hands thoroughly, turn-off faucet using the towel to eliminate recontamination of hands.
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Remember: Hand washing is the most effective way to prevent the transmission of organisms from person to person.
UNIVERSAL ISOLATION PRECAUTIONS:
Universal Precautions is the name of the isolation system used by healthcare providers. Universal Precautions is a method of
preventing the transmission of blood-borne infections. It is based on the concept that precautions should be taken with all patients
because there is no way of knowing who is infected and who is not. To observe Universal Precautions you must treat all blood and
body fluids as if they are infectious. Universal Precautions means wearing personal protective equipment for the task being
performed.
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Treat all patients as though they are potentially infectious.
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Protective equipment includes gloves, masks, eye wear and gowns.
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Wear protective equipment when at risk for exposure to blood and all moist body substances, mucous membranes or nonintact skin of all patients (i.e. gloves, gown, and eye wear as needed).
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Wash hands after removing protective equipment.
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Discard protective equipment in room. Do not wear protective equipment around the hospital.
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Use mouth to mask, resuscitation bags or ventilation devices for resuscitation.
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Clean up all blood/body fluid spills promptly with an EPA registered hospital approved cleaner.
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Never pick up broken glass by hand.
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Wear surgical mask and protective eye wear if aerosolization or splattering is likely.
If it is wet, warm and not yours,
Wear gloves to touch it!
If it is aerosolized and in the air,
Wear protective eyewear and mask!
If it drips or splashes,
Wear a gown, protective eyewear, mask and gloves!
UNIVERSAL PRECAUTIONS APPLY TO EVERY PATIENT ALL THE TIME!
AIRBORNE PRECAUTIONS:
Airborne precautions are required for patients known or suspected to be infected by airborne germs i.e. Chicken Pox, Measles, and
Tuberculosis. Some microorganisms are small enough to remain suspended in air currents and carried a long way away from the
host patient.
Patients are placed in a negative pressure room. Documentation must be done once a shift that the negative pressure is adequate
by using the monitor outside of the door.
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Air is vented directly outside.
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Door must be closed at all times.
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Wear an approved N95 Particulate Filter Respirator or use PAPR device that you have been trained to use.
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Put surgical mask on patient to transport. Avoid transporting patient whenever possible.
DROPLET PRECAUTIONS:
Droplet Precautions are used for germs that travel a short distance, no more than three feet, through the air. These germs are
deposited on a susceptible person’s eyes, nose or mouth. Germs such as Influenza, Neisseria, Meningitis, Pertussis, Mumps, and
Epiglottitis due to Haemophilus Influenza require Droplet Precautions.
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Patients need a private room, or to share a room with another patient with the same infection.
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Gloves are indicated if you anticipate having direct contact with infective substances.
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Wear a Fluid Protection mask when working within three feet of the patient.
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Put a surgical mask on the patient to transport. Avoid transporting if possible.
CONTACT PRECAUTIONS:
Contact Precautions are used for germs that travel from direct skin-to-skin contact or a contaminated object, i.e. medical
equipment/instruments. Contact transmission is the most common cause of hospital acquired infections.
Infection/colonization with multidrug-resistant bacteria:
Methicillin Resistant Staphlococcus Aureus, Vancomycin Resistant Enterococcus. (Look at culture reports- any multiple resistant
patterns.
Skin infections:
Impetigo, Scabies, Chicken Pox (also requires airborne precautions), Pediculosis (lice)
Incontinent or diapered patients with diseases spread by contact with blood or body fluids:
Shigella, Hepatitis A, Rotavirus and Clostridium difficile, E. Coli, Salmonella, Campylobacter, Yersinia.
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Place patient in private room or share with patient with same microorganism.
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Glove upon entering the room. Change gloves after direct contact with infective material.
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Gown if you anticipate substantial contact with patient or if infective material has not been adequately contained.
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Mask usually not necessary.
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Dedicate equipment such as stethoscope, BP Cuff etc. to the room if possible.
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Clean all items coming out of the room with hospital approved disinfectant.
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If patient needs to be transported, cover infected area or contain infective material if possible.
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Wash hands immediately after removal of gloves. Avoid recontamination of hands with items in the room.
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You should always perform hand washing with soap and water after caring for a patient with C. difficile. DO NOT use
hand sanitizer.
Signage: Contact and Droplet (respiratory) precautions will have the Isolation sign with correct protective equipment highlighted
or circled in order to take care of the patient. Post signs outside of the door. Airborne (TB) precautions must have the “STOP, No
Admittance without wearing an N-95 mask or more protective respirator” AND the Isolation sign with correct protective equipment
needed to take care of the patient highlighted or circled. Post signs outside of the door.
BIOHAZARDOUS WASTE DISPOSAL:
Dispose of all waste saturated with blood or body substances- if blood or other body fluids can be squeezed or crushed out of it- in
the biohazardous waste bins in our area (excluding urine, feces, bloody linen or vomitus). Bins are lined with red bags and labeled
“Biohazardous”.
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All linen is considered biohazardous. Never carry soiled linen so that it touches the body or clothing of the person
transporting it. Place soiled linen in yellow linen bag – NOT in the red or trash bag. Wet linen should be wrapped in dry
linen prior to being placed in linen bag so as to prevent seeping through. Use gloves to remove linen from bed.
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Bloody urine and feces should be flushed down the toilet.
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Sharps containers must be changed when ¾ full. It is everyone’s responsibility to change the sharps container.
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If you are injured by a sharp or get blood splashed in your eyes, nose, mouth or open wound, wash exposed area
immediately, and report to House Supervisor.
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Follow the facilities’ pharmaceutical waste program.
BLOOD OR BODY FLUID EXPOSURE FOLLOW-UP:
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Report exposure incident to the department supervisor/manager and instructor.
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Complete an electronic occurrence report. Ask your department director for assistance, if needed.
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Use safety devices when available. A needle-stick exposure usually occurs 30 seconds after removing the sharp device
from a patient. Therefore, engage the safety device immediately.
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Blood or body fluid exposures may transmit HIV, Hepatitis C or Hepatitis B.
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HIV is a virus that attacks the immune system. There is no vaccine available for HIV.
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Hepatitis C is a virus that infects the liver and can lead to serious and even fatal outcomes. There is no vaccine for
Hepatitis C.
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Hepatitis B is a virus that attacks the liver and can lead to serious illness and even fatal outcomes. There is a vaccine for
Hepatitis B which requires a series of three vaccinations. Hepatitis B vaccine is free to employees who are at risk to blood
or body fluids.
PERSONAL PROTECTIVE EQUIPMENT:
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Personal protective equipment protects you from contact with potentially infectious materials and my include gloves,
masks, gowns, aprons, lab coats, face shields, protective eyewear, mouthpieces, resuscitation bags, or other ventilation
devices.
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You must use appropriate protective equipment, each time you perform a task.
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Your equipment must fit properly.
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If equipment is penetrated by blood or other potentially infectious materials, remove it as soon as it is feasible.
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Before leaving the work area, remove all protective equipment and place it in the designated area or container for washing,
decontamination or disposal.
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Avoid unprotected mouth-to-mouth resuscitation. Always use an ambu bag/face shield. Check patient rooms at the
beginning of each shift to assure resuscitation equipment is present.
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Since gloves can be torn or punctured by sharps, bandage cuts before gloving.
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Do not pick up broken glass that may be contaminated using gloved or bare hands. Use tongs, forceps, or a brush and
dustpan.
LATEX ALLERGIES:
Report any history of latex allergies to your instructor. The hospitals will provide latex free equipment within reason. Contact the
Employee/Occupational Health nurse as needed.
PATIENT LATEX ALLERGIES:
Latex allergies are identified via the nursing assessment. If a patient indicates they have a latex allergy, latex free supplies can be
obtained from your direct supervisor. Most products are labeled latex free on the packaging.
Use a bottle opener to remove medication stoppers as some stoppers are latex. Do not pierce a needle through the stopper and
inject it into a patient. The rubber stopper is latex. Be careful when inserting invasive catheters into the patient with a latex allergy
as most catheters are not latex free.
ERGONOMICS
Ergonomics focuses on creating a work environment in which a worker should not experience physical problems from that work.
Examples of work design that may lead to physical stress include:
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Poor work-station layout
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Improper work methods, such as poor posture
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Improper work design can cause repetitive force or movement of the body without an adequate rest period for tissues to
recover. Over time, this may lead to damage of tendons, bones, nerves or muscles, typically in the hands, elbows,
shoulders, neck and back. An example would be tendonitis progressing to carpal tunnel syndrome. Certain workers are
more at risk for developing problems than others. Examples include those who:
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Perform repetitive tasks for a long time period
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Use forceful hand motion
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Must stay in a fixed position for extended periods
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Work in awkward positions
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Use excessive bending or twisting motions of the wrist
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Have continuous contact with the edge of a work surface
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Experience temperature extremes
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Use inappropriate hand tools
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Have improper sitting position
Symptoms that may appear include pain, swelling, numbness, tingling, restricted range of motion, or weakness in the affected body
part, with varying degrees of severity.
At the first sign of discomfort, the worker should take an anti-inflammatory medication, such as ibuprofen (Advil) and apply ice to
the affected area. A work analysis is often performed to correct problems that may be causing or aggravating the condition.
Realize also that obesity, pregnancy, recent weight gain, smoking, lack of general physical condition, and emotional stress may
contribute to the development of these disorders. Additionally, activities and hobbies at home can contribute to these symptoms
and adjustments may need to be made. Stress management, exercise programs, smoking cessation and counseling often are added
as part of overall medical management.
BODY MECHANICS
Healthcare workers are often subject to work that requires lifting, twisting, bending or reaching and therefore their back is at risk
for potential injury. Specifically, moving patients is a major cause of injury to employees in healthcare facilities.
Improper body mechanics increase the risk of back injury. Using proper body mechanics can protect your back against injury.
If you have to lift:
USE LIFTING EQUIPMENT WITH BARIATRIAC PATIENTS
PLAN BEFORE ACTING
(Do not attempt to do it alone if you have any doubt about your ability to do so.)
ENSURE STABLE FOOTING
(Make sure the floor is free from spills or objects that may impede your lifting.)
STAND CLOSE TO THE LOAD
SQUAT DOWN
KEEP YOUR HEAD UP
HOW TO LIFT AND SAVE YOUR BACK
You can use this technique in any lifting situation. Always remember to get help when lifting heavy or large objects such as lifting a
carton, a drum, a sack – anything.
SIX basic steps are used:
1. THE FEET: Feet should be parted, with one foot alongside the object being lifted and one foot behind. This position
gives greater stability, and the rear foot is in position for upward thrust of the lift.
2. THE BACK: Use the sit-down position and keep your back straight (Remember - straight does not mean vertical). A
straight back keeps the spine and organs of the body in correct alignment.
3. THE CHIN: Tuck in the chin so the neck and head continue the straight back line. Tucking the chin helps keep the spine
straight and firm.
4. THE PALM: The palmer grip is one of the most important elements of correct lifting. The fingers and the hand are
extended around the object you are going to lift, using the full palm. Fingers alone have little power – you need the
strength of your entire hand.
5. ARMS & ELBOWS: The load should be drawn close and the arms and elbows should be tucked into the side of the
body. When the arms are held away from the body, they lose much of their strength and power. Keeping the arms tucked
in also keeps the body weight centered.
6. BODY WEIGHT: The body should be positioned so that the body is centered over the feet. This provides a more
powerful line of thrust and also ensures better balance. Start the lift with a thrust of the rear foot.
A TIP ON TWISTING…..
Twisting during a lift is one of the most common causes of back injury. By simply turning the forward foot out and pointing it in
the direction of the eventual movement, the greatest danger of injury by twisting is avoided.
NOTE: If you lift a large amount of weight each day, a short period of loosening up is suggested just before the work day starts.
Transferring Patients
To transfer a patient between a bed and a stretcher, position the two surfaces close to each other with their heights as level as
possible. Lock both the bed and stretcher in place. Get assistance and slide the patient over. Avoid reaching all the way over the bed
and pulling. It may be helpful to use a bed sheet under the patient to help move him/her. It’s acceptable to kneel next to the patient
for better leverage and control.
To transfer a patient from a bed to a wheelchair, lower the bed and place the wheelchair beside the bed. Lock the wheelchair in
place. While facing the patient, bend knees and keep back straight. Help rock the patient to a sitting position. Rotate the patient
gently so he/she is sitting on the edge of the bed with both feet on the floor. Place one knee against one of the patient’s legs for
support. Bend knees slightly, and while keeping the back straight, place the patient’s arms on your shoulders. Pivot and lower the
patient into the wheelchair.
Reaching
Do not bend backwards while reaching. Decrease the distance to the object as much as possible. If the back cannot be maintained in
a straight position, the worker is reaching too far. This is a major problem with moving patients. Reach with arms and legs, not the
back. Staff should use a ladder or stool if they can’t comfortably reach something by them.
Standing
Standing properly is important for the back. Stand straight with knees slightly bent, hips slightly flexed, pelvis tilted forward. If it is
necessary to stand for long periods, ease some of the back strain by putting one foot on a low stool or box.
Sitting
Sit straight in a chair that supports the lower back. Keep both feet on the floor and, if possible, keep knees slightly below hips. Avoid
slouching in chairs as slouching increases back strain. Workers should situate their workstation so they are looking straight ahead
with no back twisting.
Environmental
Safety/OSHA
REPORTING INJURIES/EXPOSURES
When an injury occurs report to your Nursing Instructor
immediately!
The House Supervisor or Nurse Manager should be notified to
make arrangements for you to be seen in the Emergency
Department if needed.
All incidents are to be entered into Electronic Occurrence Report
within 24 hours.
(May need assistance of supervisor)
MountainStar Hospitals is affiliated with many universities, colleges, and technical programs. Students of various levels are
accommodated. Students are not eligible for workers’ compensation available to employees.
MountainStar Hospitals have established a security program to help protect staff, patients and visitors from harm.
Most MountainStar Hospitals have security guards/law enforcement on duty 24 hours a day. If assistance is needed from a security
guard, call the hospital operator.
As students at MountainStar Hospitals, it is our responsibility to assist in the security program by wearing the proper identification
while at work.
Identification is as follows:
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Employees/staff/volunteers/physicians – MountainStar Hospitals ID badge (worn so it can be seen)
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Patients – Identified with a wrist band
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Vendors – Identified with vendor name tag
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Visitors – No issued identification
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Students- School issued Picture ID badge
GENERAL SAFETY PRACTICES
Most on the job injuries can be prevented by following safety guidelines. Safety guidelines are not designed to make your job
difficult. Safety guidelines protect you and help you achieve your right to a safe and healthy workplace. By recognizing hazards and
knowing safety guidelines you can protect yourself, your co-workers and the patients at MountainStar Hospitals. Various
organizations, including the Occupational Safety and Health Administration (OSHA) and The Joint Commission monitor
safety practices to keep MountainStar Hospitals a safe and healthy workplace.
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Report any unsafe conditions or acts that you observe to your supervisor at once.
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Report any foreign material on the floor, or remove it at once, to prevent injury to others.
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Report defective or damaged equipment immediately.
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Walk, rather than run, especially in halls and on stairs. Keep to the right using special caution at intersecting corridors.
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Know the hospital fire safety plan. Know the location of fire alarms and extinguishers and how to use them.
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Become familiar with relevant work procedures and safe work practices.
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Open doors slowly, using the handle or push plate; make certain the other side is clear before pushing open doors.
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The work environment is no place for horseplay and practical jokes that may endanger others.
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No employee is expected to take chances or endanger themselves or others in the performance of job duties. Do not take
chances or guess! When in doubt, ask your supervisor to explain any job assignment.
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REMEMBER…the SAFE way is the RIGHT way.
GOOD HOUSEKEEPING
Slips and falls are often caused by poor housekeeping habits. In order to help eliminate slips and falls, all employees should
observe the following:
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Do not block doorways, elevators or entrances with equipment.
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Take personal responsibility to alleviate slipping or tripping conditions anywhere on the floor or stairways, or report to
Environmental Services principal hazards which may include: liquids, flower petals, rubber bands, paper clips, cigarette
butts and other small objects. Pick up trash and dispose of it properly.
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Do not use chairs, boxes, etc. for climbing. Always use a ladder.
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Approach corridor intersections and elevators slowly.
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Do not pick up broken glass by hand. Use tongs or a brush and pan, vacuum cleaner, etc.
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Linens: Protect yourself and others when you handle or transport linen.
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All linen is considered contaminated. Handle soiled linen as little as possible.
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Avoid shaking soiled linen and do not place on floor.
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Place soiled linen in appropriate linen bag at site of use.
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Report unsafe conditions immediately.
OFFICE SAFETY
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Do not use a chair, box, desk, table or unstable material in place of a ladder or step stool.
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The drawer of desks and file cabinets should be closed when left unattended.
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No more than one file drawer should be opened at any time.
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File cabinets should be appropriately loaded from the bottom drawer up, to prevent tipping.
•
Office equipment and appliances should be maintained free of slivers, burrs and other conditions which might cause an
accident or personal injury.
•
Do not operate office equipment without proper instructions.
•
Report all unsafe conditions to the supervisor immediately.
MATERIAL HANDLING
•
Avoid containers with protruding nails, jagged edges, burrs or rough surfaces. Have them repaired or get rid of them.
•
Keep fingers away from pinch points in setting down materials, passing through doorways or closing drawers and doors.
Also, when handling long objects, keep hands away from ends.
•
Wipe off greasy, wet, slippery or dirty objects before trying to handle them. Keep hands free of oil and grease. Wear
protective gloves. Use caution around operating machinery.
•
Rope slings or holders can be attached to bulky equipment to facilitate lifting; smaller items should be placed in
appropriate containers. Get help for lifting heavy equipment.
•
Use hand trucks and dollies to handle heavy, bulky or loose material. Use utility carts for moving patient equipment and
office supplies.
•
Put away sharp objects when they are not in use. Do not cover sharp objects, such as kitchen knives or tools that are on a
desk, table or workbench.
•
Needles and other sharp objects are a source of infectious disease. Immediately dispose of such objects in the nearest
needle disposal (sharps) container. Needle stick injuries require immediate follow up. Use proper safety devices when
breaking glass ampules.
•
Do not reach into wastebaskets.
•
Use caution while handling hot liquids or materials.
•
Never pick up broken glass by hand. Always use mechanical devices such as a broom and dust pan or vacuum cleaner.
HAZARDOUS MATERIAL MANAGEMENT
To provide a safe environment for patients, visitors and employees and the surrounding community MountainStar Hospitals has
initiated the proactive management of hazardous and potentially hazardous materials, wastes or conditions. Policies and
procedures are written regarding safe handling, storage use and disposal of all hazardous materials.
Labels on chemicals provide important safety information and offer a quick reference to the chemicals hazards. Protect yourself by
always taking the time to carefully read chemical labels before you move, handle or open a chemical container.
YOU HAVE A RIGHT TO KNOW ABOUT THE HAZARDOUS MATERIALS WITH WHICH YOU WORK.
Each hospital department/area is responsible for identifying and labeling all hazardous materials and waste used within that
department/area. The Department Director/Supervisor is responsible to provide notification of the chemicals, potential health
hazards, handling procedures and emergency procedures. Each manager is responsible to provide department specific training for
chemicals used in their area.
Containers of hazardous materials must always be properly labeled with identity, hazardous ingredients and the chemical
manufacturers name and address. Labels must show hazard warnings appropriate for employee protection. Chemicals that are not
in their original container required labels. Sometimes a product is poured into a smaller more usable container. It is essential that
the smaller container have a label with the chemical identity, name and address of the manufacturer, hazards associated with its
use and target organs affected by the chemical.
Spill kits are located in the hospital: Follow hospital spill protocol.
If you are not sure about exposure and/or clean-up, ASK FOR HELP. Do not put yourself and others in danger.
SDS
Safety Data Sheets (SDS) provides detailed information on particular chemicals. They give details on chemicals and physical
dangers, safety procedures, and emergency response techniques. In the case of an exposure or spill, an SDS sheet can be obtained
via the facility intranet site. You will need to supply the 3E representative with the following information:
Manufacturer Name
Product Name
Fax Number
Upon request the 3E representative will stay on the line and explain the MSDS and offer support.
CYLINDER SAFETY
Gases are stored in cylinders under high pressure. Follow these basic rules when handling gas cylinders.
•
Secure cylinder at all times. Attach to wall or other stable object such as a patient bed or stretcher. Never leave a cylinder
freestanding, regardless of the cylinder contents. Stem rupture causes a cylinder to become a torpedo!
•
Transport cylinders in cylinder carts. Large cylinders should be stored and transported with protective caps. Never carry
a cylinder in your arms.
•
Bleed disposable cylinders before replacement. Relieve all pressure to zero p.s.i. as these cylinders are disposed of by
crushing and may become a danger if pressure is left inside.
•
Remove cylinders to main department storage area or Materials management when empty.
•
Teach patients how to handle regulators and to take precautions.
•
No smoking around cylinders. Keep away from sources of heat.
•
Keep petroleum-based products (i.e.: oil, grease Vaseline) and spark-producing equipment, such as electric razors, away
from oxygen. Oxygen is not flammable but greatly enhances combustion.
•
Never interchange a regulator used with a specific gas, with a cylinder intended for another gas.
MACHINES/EQUIPMENT
Each of us comes in contact with electrical and mechanical equipment, including power and hand tools. The following are general
practices to reduce accidents.
•
Never operate a machine or a piece of equipment until instructed in safe operation.
•
Make absolutely certain that all personnel are clear of the machine or equipment before it is started. Walk around it, if
necessary, and/or give the proper warning signal before starting-up.
•
DO NOT OPERATE MACHINES WITOUT APPROPRIATE GUARDS. Machine guards have been installed for safety.
Keep them in place when the machine is operating and replace any missing guards that have been removed for repair or
adjustments. Missing or inadequate guards should be reported to your supervisor immediately.
•
Turn off and unplug the equipment before machine repairs or adjustments are made. There are no exceptions to this
practice.
•
Personal protective equipment, such as gloves, safety glasses, ear protection, hard hats, safety clothing, etc. may be
required in certain operations. Your supervisor will provide the personal protective equipment necessary for each job.
•
All equipment coming into MountainStar Hospitals must be inspected by the Biomedical Department before being put
into use. All equipment is inspected yearly by the Biomedical Department. Check all equipment before using for a date on
the label. If the date is past due, do not use the equipment but send it to Plant Operations immediately with a work order
explaining the problem.
•
Biomedical Department has identified all equipment in the hospital by priority. Priority-1 devices are described as: “lifesupport equipment and other devices whose failure is associated with serious or potentially serious accidents,” require
additional instruction on the units. The Department Directors are responsible for recording and maintaining all the
documentation of training.
Emergency Codes & Numbers
There are instances in the hospital that require immediate emergent attention. An emergency overhead code system has been
designed to alert the hospital of emergencies. The code and access number for the various emergencies are listed as follows:
Code
Description
Response
Follow-up
Code Blue
Arrest and/or medical
-Call for help
N/A
emergency
-Start CPR if necessary
-Provide First-aid
-Code Team will respond
Code Red
Fire
-Report Fire
Complete report of
Alert others
Incident.
Close doors and check exits
DO NOT USE ELEVATORS
Know your evacuation route
Listen for instructions
Code Pink
Missing Persons/
All exits (including elevators) must be
Follow up with Security
Infant Abduction
monitored by employees until
and complete report
code is cleared.
of incident.
Check non-patient care areas.
Code Silver
Active Shooter
Turn off cell phones
Debriefing will be
Run, Hide, Fight
Provided.
Evacuate the building
In case of an emergency, notify the operator immediately by activating the appropriate Code alert as listed above. Policies and
procedures for managing emergent situations are found on the Intranet under Policies and Procedures - Environment of Care.
FIRE PREVENTION
•
Fire extinguishers are available in designated areas. Learn the location and proper use of fire extinguishers.
•
Most fire extinguishers are ABC extinguishers and will put out trash, liquid and electrical type fires.
•
To use a fire extinguisher, set the extinguisher on a solid surface and Pull ring out. Do not hold extinguisher by the lever
handle or the pin cannot be removed. Stand back 8 feet from the fire and Aim at the base of the fire. Squeeze the lever.
Sweep from side to side to put out the fire.
•
Passageways and work areas around fire extinguishers must be kept clear at all times.
•
Report worn or frayed wires.
•
Extension cords are not allowed.
•
Extinguishers that appear to have been used or tampered with should be reported to the Plant Operations Department
immediately.
•
No open flames or smoking are permitted within 25 feet of the hospital.
•
Patient and corridor exit doors shall not be obstructed. Know how to exit from the work area.
•
Report fires by pulling the fire alarm and dialing the operator. DO NOT RISK trying to extinguish a fire before signaling
for help.
•
Be alert in recognizing fire hazards and fire prevention.
•
Know fire and evacuation plans for the work site.
•
Announcement of “Code Red” on hospital intercom indicates a fire alarm within the hospital.
FIRE PROCEDURE (RACE)
RESCUE
Rescue anyone who is in immediate danger from the fire.
Simultaneously notify other staff of the fire and its location.
ALARMS
Sound the fire alarms by pulling the nearest manual pull station.
CONFINE
EXTINGUISH
Confine the fire by closing all the doors in and around the fire area.
Do not turn off the lights.
Extinguish the fire by using a portable fire extinguisher, if safe to do so
and only if you are unable to relocate the patient.
OPERATING PORTABLE FIRE EXTINGUISHER (PASS)
PULL
Pull the pin.
AIM
Aim the nozzle or cone at the base of the flame.
SQUEEZE
Squeeze the handle.
SWEEP
Sweep the nozzle from side to side at the base of the flames.
NOTE: PASS will work for most fire extinguishers. However, one must become
familiar with all fire extinguishers in the work area.
Patient Rights and
Responsibilities
Patient Rights
Patients in our hospital have both rights and responsibilities. Our goal at MountainStar Hospitals is for staff and students to
recognize and respect the rights of all of our patients.
Patients have the right to:
•
Reasonable access to care and continuity of care.
•
Care that is considerate and respectful of personal values and beliefs.
•
Be informed and participate in care decisions.
•
Receive the name of the person in charge of their care.
•
Complete, current information concerning diagnosis, treatment options, and expected outlook in understandable terms.
•
Participate in ethical decisions that might arise.
•
Request or refuse treatment.
•
Have a family member and physician notified promptly of admission.
•
Expect reasonable safety insofar as the hospital’s practices and environment are concerned.
•
Be free from all forms of abuse or harassment.
•
Be free from restraints or seclusion that are not medically necessary or are used as a means of coercion, discipline,
convenience, or retaliation.
•
Privacy and security to the extent consistent with adequate medical care and confidentiality of all records pertaining to
treatment, except as otherwise provided by law or third-party payment contract.
•
Request an itemized explanation of charges.
•
Know about the facility’s rules and regulations that apply to conduct.
•
Reasonable response to the request for services.
•
Make advance health care decisions.
•
Information about pain and pain relief measures provided by staff.
•
Treatment without discrimination regardless of race, color, religion, sex, national origin, source of payment, political
belief, or handicap, including services for hearing and speech impaired.
•
Access a patient representative to express grievances and suggestions to the organization.
•
Information necessary to provide informed consent prior to any procedure and/or treatment.
•
Access protective services, which include assistance relative to guardianship and advocacy services, conservatorship, and
child or adult protective services.
•
Access pastoral care and other spiritual services.
•
Effective communication including services without cost for hearing and speech impairments.
•
Request transfer to another facility.
•
Provide complete and accurate information about medical history, present complaints and other matters relating to
his/her health.
•
Report unexpected changes in his/her condition.
•
Report whether he/she clearly comprehends a contemplated course of action and what is expected of him/her.
•
Follow the hospital’s rules and regulations.
•
Follow the treatment plan.
•
Provide accurate financial information
•
Show respect and consideration to other patients and hospital personnel.
Patients also have the responsibility to:
EMTALA
The Emergency Medical Treatment and Labor Act is a federal law that requires hospitals to treat all people who request emergency
care.
Employee/Student Responsibility
•
Never direct a person seeking emergent care to another hospital or facility even if the person requiring treatment refuses
to stay at the hospital. Hospitals cannot force individuals to receive treatment, however:
•
If the individual insists on leaving or going elsewhere for treatment, it is important to give them information regarding the
possible risks and benefits involved in both staying and leaving.
•
It is vital to document the individual’s refusal of treatment.
•
Contact your supervisor if you have any questions.
Confidentiality
And the
Medical Record
Confidentiality and the Medical Record
HIPAA (Health Insurance Portability and Accountability Act of 1996) and its implementing regulations set forth a number of
requirements to ensure the privacy of protected health information (PHI).
Everyone is responsible for protecting patients’ individually identifiable health information. Any piece of paper that has
individually identifiable health information on it must be disposed of in appropriate Shred-It receptacles. The paper will be
handled and destroyed securely. The elements that make information individually identifiable include:
Patient name
Social security number
Telephone numbers
Fax numbers
E-mail address
Address, including city, street, county, and zip code
Name of employer
Name of relatives
Certificate/license numbers
Dates (birth, admission, discharge death, age)
Medical record number
Health plan beneficiary number
Account number
Photographic images
Telephone numbers
E-mail address
Any member of the workforce with a legitimate need to know to perform job responsibilities may access a patient’s health
information. However, the amount of information accessed should be limited to the minimum amount necessary to perform the
job responsibilities.
Policies prohibit employees and students from accessing their own records in Electronic Medical Record. Employees and students
may, however, fill out the appropriate consent in HIM (Health Information Management) and can obtain a copy of their records.
How does HIPAA affect you?
•
Patient information should only be accessed if there is a need to know - that is, if you are assisting in the treatment of
that patient and the information accessed is needed to perform your professional duties. This includes the electronic
medical record as well as printed documents.
•
You may NOT discuss a patient’s care or treatment with friends or family members without patient consent.
•
PHI should not be discussed in public places like the cafeteria, elevators, or public hallways.
•
Patient records may not be photo copied or printed from a computer terminal for personal use. (i.e. writing care plans,
case studies or other papers)
•
Students do not release any patient information independently.
•
Any request for patient information should be directed to your preceptor/supervisor.
Appropriate Access and Information Security
•
Treat all information as if it were about you or your family
•
Access only those systems you are officially authorized to access
•
Access only the information you need to do your job
•
Only share sensitive and confidential information with others who have a “need to know.”
•
Always log out, activate a screen saver or suspend the session on your terminal when leaving your immediate work area
•
Close doors when discussing treatments and administering procedures.
•
Do not leave intact information in the trash can. Shred all records or dispose of in locked bins to be shredded later.
•
Do not use cell phones or other electronic devices to take or send photographic images and/or audio/video recordings of
patients or medical information.
•
No portable devices or removal media.
•
Will not publish or disclose any confidential information to other using personal email, or to any internet sites, or to any
internet blogs, or any social media sites.
Documentation Guidelines
Each patient’s medical record is legal proof of the quality of the care that was provided. The electronic medical record is important
in that it: will help the healthcare team plan for continuous, quality patient care, coordinate the care that each healthcare team
member contributes and keep each member informed about the patient’s condition and treatment.
General Documentation Guidelines:
•
Only persons directly involved with patient care should access and document in the electronic medical record.
•
All entries into electronic medical record are made by the individual under his/her own login only.
•
Notes must be in chronological order.
•
Notations must consist of facts and exact observations, rather than opinion or interpretations of an observation.
•
All information entered into the medical record must be complete and helpful to the patient and healthcare team.
Examples are: admission note, admission assessment, behavior changes, signs and symptoms that are severe, tend to
recur or persist, get worse, indicate a complication, are not relieved by prescribed measures, indicates faulty health habits,
or is a known danger signal.
•
Abbreviations on the “unapproved” or “do not use” list are never to be entered into the medical record. Refer to “do not
use abbreviation” lists in Policies and Procedures for a list of abbreviations that are never to be used.
Remember that all patient information must be kept confidential and secure!
•
Always log off the computer system when you leave the workstation.
•
Access only the records of patients assigned to you.
•
Don’t engage in casual conversations about patients.
•
Notify the charge nurse if you see someone that you don’t know looking at the medical record.
•
Dispose of any material with a patient name on it (change of shift reports, handwritten notes, etc.) in the “confidential”
receptacles.
•
Do not view your own or your family member’s medical record through Electronic Medical Record.
•
Do not remove any papers or other articles that contain any patient identifying information from the hospital.
Do not share your user ID or password!
National Patient
Safety Goals
National Patient Safety Goals
The purpose of the National Patient Safety Goals is to improve patient safety. The goals focus on problems
in health care safety and how to solve them.
All Joint Commission accredited health care organizations are surveyed for implementation of the following Requirements-or
acceptable alternatives-as appropriate to the services provided. Alternatives must be at least as effective as the published
Requirements in achieving goals. Failure by an organization to implement any of the applicable Requirements (or an acceptable
alternative) for a National Patient Safety Goal will result in a special Requirement for Improvement for that goal.
Students are responsible to following these National Patient Safety Goals and checking the website for annual updates.
Click on the blue hyperlink above to access the current National Patient Safety Goals.
Important Patient
Care Related
Information
Patient Care
Spiritual Aspects of Care and Pastoral Care Provisions
The patient/family can expect his/her belief system will be respected with utmost consideration, within the restraints of the
hospital policy. The staff will consider the patient’s individual religious/spiritual practices when planning and implementing care.
MountainStar Hospitals patients have access to pastoral care services either through their own spiritual advisors, or through the
hospital’s non-denominational Pastoral Care Services.
Patient Assessment
The goal of assessment is to determine the appropriate care, treatment, and services to meet a patient’s initial and changing needs
while in the hospital and to provide the patient the most optimal care and treatment possible. The assessment process will be a
continuous, collaborative effort with all departments functioning as a team. Patient assessment is an interdisciplinary function that
involves input by various members of the health care team. Identifying and delivering appropriate care, treatment, and services
depends on three processes:
•
Collecting data about each patient’s health history; physical, functional, and psychosocial status; and needs as appropriate
to the setting and circumstances.
•
Analyzing data to produce information about patient’s needs for care, treatment, and services and to identify the need for
additional data.
•
Making care, treatment, and service decisions based on information developed about each patient’s needs and the
response to care, treatment, and services.
Interdisciplinary Care Planning Process
MountainStar Hospitals ensures that care is planned to respond to each patient’s unique needs, expectations and characteristics
with effective, efficient, and individualized care based on needs identified in the assessment process. Care is planned and provided
in an interdisciplinary, collaborative manner by qualified individuals. The care planning process identifies goals for care,
treatment, and rehabilitation in the most appropriate setting with services required to meet the goals. A written plan of care is
initiated with 24 hours of admission and is updated and/or revised as needed or upon the initiation of each new service/treatment
modality or reassessment of the patient.
Restraint and/or Seclusion—Behavior Management
Restraints for Behavioral Management are used when the patient is exhibiting violent or aggressive behavior or behavior where
he/she might hurt self or others. Restraints for Medical Management are used when a patient is trying to pull out lines, catheters,
or other therapeutic devices or cannot follow directions to prevent self-injury. MountainStar Hospitals’ goal is to eliminate all
unnecessary use of restraint and reduce restraint use to emergencies only or when no other intervention has worked. Please refer
to the policy for detailed information about the use of restraints including assessment, alternatives, monitoring, and
documentation.
Pain Management
MountainStar Hospitals’ health team recognizes that pain can be part of the patient experience and unrelieved pain has adverse
physical and psychological effects. The patient’s right to an appropriate assessment and management of pain is respected and
supported. Services for patients are provided in such a way as to respect and foster their sense of dignity, safety, autonomy,
positive self-regard, civil rights and involvement in their own care. The ethical obligation to manage pain and relieve the patient’s
suffering is at the core of a health care professional’s commitment.
Patient-Controlled Analgesia Infusion (PCA)
Patient-controlled analgesia (PCA) is a method of providing analgesia using a computerized pump that allows patients to selfadminister predetermined doses of opioids. The delivery of small, frequent intravenous boluses of opioids results in reasonably
constant serum concentrations of the opioid. This policy includes general information about PCA therapy and procedural
guidelines to be followed. The programming, monitoring, and trouble-shooting of PCA pumps is not to be done independently by
students, it must always be supervised by a MountainStar Hospitals RN or by student faculty.
Epidural/Intrathecal Analgesia
This policy gives guidelines for safe administration of narcotics &/or anesthetic agents into the epidural or Intrathecal space. This
method of pain relief is useful for patients who have experienced major surgery or severe, chronic pain. Epidural/Intrathecal
medications may be administered as an intermittent infusion with an Anesthesiologist or CRNA administering manual boluses of
narcotic, by continuous infusion through a specially designated infusion pump and as a Patient Controlled Epidural Infusion
(PCEA) through via an infusion pump. These patients require close monitoring by nurses who have successfully completed an
Epidural/Intrathecal Self Study and demonstrated competency. Student nurses will work closely with the RN to monitor the
patient for side effects, complications and pain relief.
Pressure Sore Prevention, Treatment, and Documentation
This policy is intended to address pressure sore prevention, treatment, and documentation. This policy includes nursing guidelines
for skin assessment and for prevention of pressure sores, guidelines for prevention of pressure sores, guidelines for use of
documentation tools, guidelines for staging of pressure ulcers, and guidelines for management of pressure ulcers based on staging
criteria.
General Administration of Medications
Once students have been deemed competent by their respective instructors they are allowed to administer medications in the
Electronic Medical Record but must have a required co-sign by an RN and follow the medication administration and disposal
policy.
Blood/Blood Components Administration
This policy is written to outline the procedures and equipment necessary for obtaining, administering, and documenting the use of
blood or blood components. Each MountainStar Hospital has its own requirements before students participate in the practice of
Blood Administration.
Medication Administration Record
MountainStar Hospitals utilizes an electronic system for medication administration in all inpatient and outpatient areas of the
hospital. This system utilizes bar coding technology and provides a safer medication administration process. The students utilize
bedside barcode scanners to scan patient identification bands and bar coded medication doses each time they administer
medications to the patient. An “electronic medical record” or “eMar” is generated and becomes a permanent part of the patient’s
medical record. This technology ties the patient, physician order, pharmacy and the nurse together by providing an instant
warning to the nurse when any of the “ rights” of medication administration are violated. Students will utilize this technology only
after receiving formalized training and while being supervised by their respective instructors or a MountainStar Hospitals staff
nurse.
IV Therapy, Peripheral: Admixing and Dosage Calculations; Tubing; Site Selection, Site Preparation,
and Dressings; Administration Guidelines; Maintenance
This policy is written to outline various procedures surrounding Peripheral IV Therapy, including: equipment, admixing and
dosage calculations, site selection, site preparation, initiation of peripheral IV, site dressings, administration guidelines,
maintenance, considerations when discharging a patient with an IV lock in place, and utilization of the single/dual channel IV
pump. Initiation of a peripheral IV and initiation, programming, troubleshooting of an IV pump is not to be done independently by
nursing students, but must always be supervised by a MountainStar Hospitals RN or clinical faculty.
Cultural Diversity
and Sensitivity
W HAT IS CULTURE?
Culture is the values, beliefs and practices shared by a group of people. We have an obligation to be respectful and sensitive to
another’s belief system (co-workers, patients, families). It’s important to be culturally competent and comfortable with those we
serve and serve with by examining our own personal biases and cultural values and understand how they may inhibit effective
communication.
HOW TO BE CULTURALLY COMPETENT
Ask yourself these questions:
•
Who are my customers?
•
How can I learn about them?
•
What are my beliefs about this group?
•
Acquire basic knowledge of the cultural values, beliefs and practices of your customers:
o Ask questions
o Listen
o Account for language issues
o Be aware of communication styles
Be sensitive to personal health beliefs and practices
As a student, ask your supervisor/preceptor to help you find the answers to the following questions:
•
How does the patient stay healthy?
o Special foods, drinks, objects or clothes
o Avoidance of certain foods, people or places
o Customary rituals or people used to treat the illness
•
What are the expectations for medicine usage?
o Past experiences with medicine usage
o Will the patient take medicine even when he/she doesn’t feel sick?
o Is the patient taking other medicines or anything else to help them feel well?
•
Family and community relationships
o Are illnesses treated at home or by a community member?
o Who in the family makes decisions about health care?
o Who in the family is your support system?
•
Language barriers
o Can the patient understand limited English?
o Consider literacy level
o Use visual aids and demonstrate procedures
o Check understanding
o Is an interpreter necessary? If yes, follow hospital guidelines by using a trained medical interpreter. Avoid using
family members.
•
Body language
o Is there cultural significance for:
o Eye contact
o Touching
o Personal space
o Privacy / modesty
o Other cultural factors to consider
o Gender
o
o
•
Wealth or social status
Presence of a disability
Sexual orientation
•
Religious / Spiritual beliefs
•
Are there sensitivities / beliefs associated with:
•
Birth, death
•
Certain treatments, blood products
•
Prayer, medication and worship
•
Food preparation, clothing, special objects, and gender practices
Student Orientation Booklet Quiz
1)
The Patient Rights and Responsibilities document outlines the rights afforded to each person who is a
patient in a health care facility. As a student, you have the responsibility to help carry out this commitment.
Which statement best defines patient’s rights?
a) The healthcare provider will provide an environment of trust
b) All patients can feel comfortable and confident with the sensitive care they receive
c) Quality care will be given regardless of race, color, religion, sex, age, national origin, physical or mental
disability, veteran status, and/or the ability to pay
d) All of the above
2)
Patients Rights and Responsibilities will be posted:
a) Near the restroom
b) In binders stored in drawers
c) Throughout all healthcare organizations
d) They are never posted
3)
We have an obligation to be respectful and sensitive to people’s cultural differences (co-workers, patients,
families). What is culture?
a) The arts
b) Costumes worn by various nationalities
c) Values, beliefs and practices shared by a group of people
d) Ancient civilizations
4)
Language is a very common cultural barrier. How should you communicate to a person who doesn’t speak
English?
a) Utilize a family member
b) Use hand signals
c) Speak louder
d) Use a trained medical interpreter
5)
The best completion of the statement: “Safety is _____________ concern” would be:
a) The hospital staff’s
b) Everyone’s
c) Employee Health’s
d) The Security Department’s
6)
What is one common thing you can do to prevent the spread of infections?
a) Wash your hands with soap and water or sanitize your hands with an alcohol-based hand rub
b) Wear gloves at all times
c) Wear PPE at all times
d) Only care for one patient
7)
A patient with MRSA in their urine is in Contact Precaution. Which of the following items of personal
protective equipment should be in use by an individual before entering the room to check on the patient?
a) Gloves
b) Gown
c) Shoe covers
d) Both a & b
8)
“Red Bags,” which are for Infectious waste should be used when:
a) The waste looks really offensive
b) If blood or other body fluids can be squeezed or crushed out of the container
c) There are no other receptacles available and no time to get to one
d) There is a chance of the contaminate getting on your clothes or hands
9)
When lifting objects, it is best to keep your feet close together.
a) True
b) False
10) Which of the following activities could cause an injury to your back:
a) Moving a patient from the bed to a wheelchair
b) Reaching for an object
c) Getting up from a chair
d) All of the above
11) In your role as a student, while you are transferring a patient to another department you accidentally run
over your foot with a stretcher. You think your toe is broken. You should:
a) Go immediately to the ER and they will treat you without payment
b) Contact your family and go to an ER that is not in your assigned area
c) Contact the Workman’s Compensation office
d) Report to your instructor, who can help you determine how the school and your own insurance will
cover the costs of caring for your foot
12) HIPAA requirements are:
a) Written to protect only those patients who attend AA meetings
b) Laws and regulations for the use and release of private health information
c) Written to provide a checklist for patients to protect their identifiable health information
d) All of the above are HIPAA requirements
13) A good question to ask yourself before looking at patient information might be?
a) Does this person live in my neighborhood?
b) Do I need this information to perform patient care?
c) Would the newspaper like to know about this information?
d) Does anybody really care about this?
14) Which one of the following is an additional step to protect a patient’s privacy:
a) Close room doors when discussing treatments and administering procedures
b) Try to build a relationship with their family members
c) Stay logged in to computer terminals on which you have viewed electronic medical records
d) Throw patient-identifiable information in the trash can whole, don’t shred or destroy it
15) In order to release information to a party you do not know, a student needs to verify the individual’s identity
by asking for:
a) The patient’s name and knowledge of the information that is to be released
b) A student should never independently release information to a requesting party
c) The patient’s name and diagnosis
d) The patient’s name, physician and diagnosis
16) “PPE” stands for:
a) Personal Protective Equipment
b) Peripheral Protective Engagement
c) Positive Protective Equipment
d) Pre-sterilized Powdered Emergent
17) The National Patient Safety Goals set by the Joint Commission on Accreditation of Healthcare
Organizations (Joint Commission), were created to include which of the following:
a) Improve the Accuracy of Patient Identification
b) Improve patient safety
c) Implement the P.R.O.P. protocol throughout the system
d) Improve the use of fire extinguishers in emergency situations
18) A fire has been identified and the patient has been safely removed from the area. The next step is to:
a) Alert the hospital staff that there is a fire.
b) Pull the fire alarm for quick response.
c) Assist Engineering in extinguishing the fire.
d) Stay where you are and scream really loud because you are afraid.
19) Which of the following is considered a safety risk?
a) Keeping floors clean and dry
b) Keeping traffic areas clear of clutter
c) Running through the hallways and pushing open doors
d) Reporting defective or damaged equipment
20) I have read and understand this document and its contents and will discuss any questions with my
instructor:
a) I agree
b) I disagree